The CDC has estimated that there will be 172,800 people alive with AIDS in 1991. The cost of providing personal medical care for these individuals is estimated to be $8.5 billion in 1991, for an average of $50,000 per patient alive. When an AIDS patient is also an IV drug user (17 per cent of all cases), the costs are higher still, both because of the poorer initial health status of this population and the weak support networks in the drug community. Unnecessary hospitalization is a major contributor to these escalating costs. Such hospitalization is also detrimental to the emotional well-being of these patients. Timely discharge for those with AIDS is often impeded by the presence of service, financial, or other barriers to care. When the patient is also an IV drug user, the barriers may be even greater. No systematic examination of these barriers has been conducted, however. This study intends to (1) identify the barriers which prevent discharge of AIDS patients from the hospital when medically ready; (2) rank each of these barriers in order of their importance in preventing discharge; and (3) determine if there are differences in the barriers or their relative importance associated with the concentration of AIDS patients in the community, the race of the patient, and/or the source of acquisition of the syndrome (homosexual behavior or intravenous drug use and related heterosexual and childhood cases). The Delphi Method will be employed to gain consensus on the barriers to outpatient care. Experts in the field will be interviewed in the first round and will be contacted by mail for each succeeding Delphi round. A questionnaire and a survey instrument for use in the second stage of the research will be developed at this time. Using these two measures, the case records of AIDS patients (N=400) will be examined to determine the causes of delay in discharge, their order of importance, and the relative contribution of patient concentration, race, and source of acquisition of AIDS to delays in discharge. Special attention will be paid to the northern New Jersey area where an extremely high concentration of IV drug-related AIDS cases are found. If only one day's hospitalization could be avoided and replaced with home care or nursing home care for each patient alive with AIDS in 1991, between $85 and $130 million could be saved. In addition to this financial benefit, the study results will lead to more informed policy decision-making, so that scarce resources can be used to provide the support necessary for prompt discharge and the maintenance of emotional well-being.